Adolescent ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Poisoning ; mortality ; therapy ; Survival Rate ; Treatment Outcome ; Unithiol ; therapeutic use

Objective To investigate the related risk factors,clinical features and prognosis of hospital-acquired acute kidney injury (AKI) in intensive care unit (ICU).Methods We retrospectively analyzed 48 patients with both acute kidney injury and multiple organ dysfunction syndrome (MODS),who received renal replacement therapy from October 2006 to February 2011 in our ICU.According to whether the occurrence time of AKI was 48 hours after admission,they were divided into hospital-acquired AKI (HA-AKI) group and community-acquired AKI (CA-AKI) group,with 13 and 35 cases respectively.We compared the differences between these two groups in gender,age,acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ),primary diseases,days of mechanical ventilation,times of renal replacement therapy,number and indicators of organ failure,prognosis,renal function recovery,length of stay in ICU and hospital.Results The mean age of HA-AKI group is ( 64.5 ± 21.4) years,which is older than that in CA-AKI group ( 50.2 ± 17.5 ) years (P=0.022).The top three primary diseases in CA-AKI group are severe infection(42.8％ ),chronic kidney disease (CKD) concurrency of AKI ( 11.4％ ) and multiple trauma without head injury ( 8.6％ ).However severe infection still occupies the first in HA-AKI group ( 30.8％ ),followed by stroke (23.1％,P=0.024),multiple trauma with head injury( 15.4％,P=0.018 ) and gastrointestinal bleeding( 15.4％ ) ;Patients in HA-AKI group with more than four organ failures account for 84.6％,significantly higher than 65.7％ in CA-AKI group (P=0.000).On the first day,the levels of serum sodium ( P =0.036 ) and bicarbonate ( P=0.001 ) in HA-AKI group are higher than that in CA-AKI group,and the urinary volume is more(P =0.046).In HA-AKI group,the level of urea nitrogen on the seven day increases so progressively that it becomes significantly higher than that on the first day(P=0.015),but in CA-AKI group,there is no significant change in the levels of serum creatinine and urea nitrogen after AKI,while the levels of seruum sodium ( P=0.023 ) and bicarbonate ( P=0.030) increase significantly;APACHE Ⅲ score in HA-AKI group after admission 24 hours is significandy lower than that in CA-AKI group(53.2 ±22.8) point vs (89.1±25.7) point,P=0.000),and the length of stay in ICU and hospital and days of mechanical ventilation in HA-AKI group are significantly longer than that in CA-AKI group,but there are no significant differences in times of RRT therapy,prognosis and recovery of renal function.Conclusion APACHE Ⅲ score after 24 hours of admission does not accurately reflect the prognosis of patients with MODS and HA-AKI.There are great differences in age,primary diseases,organ function changes and other aspects of HA-AKI when compared with CA-AKI.

Objective Toinvestigatetheoperativeeffectandsafetyofendovascularstentingfor thetreatmentofsymptomaticvertebralarteryostialstenosis.Methods Fortypatientswithsymptomatic vertebral artery ostial stenosis and stenosis rate ≥70% were admitted to the Department of Neurology, China-Japan Friendship Hospital from November 2010 to January 2013 were enrolled retrospectively. All patients received endovascular stenting therapy,15 of them were implanted bare metal stents,and 25 were implanted drug eluting stents. The technical successful rate of operation,perioperation complications,and symptom remission rate of the patients were analyzed. At the same time,stroke and death incident as well as the related ischemic symptoms of the stent vascular feeding area in the follow-up period (13 to 36 months)wereobservedandtherestenosisratewasdocumented.Results Atotalof42stentswereimplanted in 40 patients,and the technical success rate was 100. 0%. The preoperative stenosis rate of vertebral artery ostial stenosis was 75% to 99%(mean 85 ± 7%);the postoperative stenosis rate was 0% to 20%(mean 6 ± 4%). There was no perioperative complication. The clinical symptoms of 19 patients disappeared completely,16 were improved significantly within the follow-up period,and the symptom remission rate was 87. 5%. No stent vascular feeding area related stroke and death occurred. Four patients had transient ischemic attack in posterior circulation,13 had restenosis after procedure (10 of them with bare mental stents and 3 with drug eluting stents). There was significant difference in restenosis rate between the bare mental stents andthedrugelutingstents(10/15vs3/25,P=0.001).Conclusion Endovascularstentingforthe treatment of the severe symptomatic vertebral artery ostial stenosis is a safe and efficient method. Although its restenosis rate is high,but it can improve the symptom of posterior circulation ischemia effectively.

Objective To understand the level and distribution of antibody F1 against plague in population of Ningxia natural plague foci in 2007 and 2008. Methods Seven hundred and eighteen blood samples were collected in five major cities and counties of natural plague foci, and 475 blood samples were collected in nonplague area as control group. Conventional indirect hemagglutination, colloidal gold test, and enzyme-linked immunoassay were employed to test the antibody. If the result was tested positive by more than two methods used then the result was defined as positive. Antibody titer that did not reach the positive standard was defined as suspected samples. Results A total of 718 serum samples were tested, the results showed that 9 samples were positive (antibody titer was 1:16 - 1:64), the positive rate was 1.25%(9/718), suspected samples was 28, the detection rate was 3.90%(28/718). Four hundred and seventy-five serum samples in the non-plague area were all negative by the three methods. There was a significant difference of antibody F1 positive rate between residents in historical epidemic area and history nonepidemic area(χ2 = 4.44, P< 0.05). There was no statistical significance of the positive rate[1.25%(9/718), 1.25%(9/718),2.51%(18/718)]among the three methods used(χ2 = 1.91, P> 0.05). Conclusion There still exists a certain proportion of Fl antibody positive people in Ningxia natural plague foci, and these people are distributed in areas where several animal plague prevalent in recent years.

OBJECTIVETo screen effective constituents of Discocleidion rufescens against bacteria.

METHODCompounds were isolated by bioassay-guided fractionation method with various chromatographic methods and their structures were determined by spectral analysis and chemical evidence.

RESULTSeven compounds were isolated from the Et2O and n-BuOH extracts and identified as 5,7-dihydroxy-4'-methoxy flavone (1), quercetin (2), apigenin-7-O-beta-D-glucopyranoside (3), apigenin-7-O-neohesperidoside (4), luteolin-7-O-neohesperidoside (5), gallic acid (6) and beta-daucosteol (7).

CONCLUSIONCompounds 1-6 were isolated from genus Discocleidion for the first time and exhibited certain inhibitory activity against Escherichia coli. Compound 6 also showed antibacterial activity against Staphylococus aureus.

Anti-Bacterial Agents ; analysis ; isolation & purification ; pharmacology ; Escherichia coli ; drug effects ; Euphorbiaceae ; chemistry ; Plant Extracts ; analysis ; isolation & purification ; pharmacology ; Staphylococcus aureus ; drug effects

Adult ; China ; Diagnostic Errors ; Diphtheria ; diagnosis ; Female ; Humans

OBJECTIVESTo investigate the efficacy of transperineal seminal vesicle puncture under ultrasound guidance and continuous transcatheter antibiotic drugs instillation for the treatment of chronic seminal vesiculitis.

METHODSForty-two patients with hemospermia were treated from April 1988 to January 2001. Of them 35 patients with urogenital inflammation were treated by transperineal seminal vesicle puncture under ultrasound guidance and continuous transcatheter antibiotic drugs instillation.

RESULTSTransperineal seminal vesicle puncture and continuous transcatheter antibiotic drugs instillation therapy was adopted for 35 patients with urogenital inflammation and the cure rate was 91.43%.

CONCLUSIONSTransperineal seminal vesicle puncture under ultrasound guidance and continuous transcatheter antibiotic drugs instillation was an effective method for diagnosis and treatment of chronic seminal vesiculitis.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Chronic Disease ; Genital Diseases, Male ; drug therapy ; Humans ; Inflammation ; drug therapy ; Male ; Middle Aged ; Punctures ; Seminal Vesicles

Objective To evaluate the additional efficacy of local anesthetic injection (LAI) as a part of multimodal anal?gesia in patients undergoing total knee arthroplasty (TKA) with respect to pain, narcotic use, knee function and complications. Methods A multicenter randomized, controlled, double blind study was performed. A total of 101 patients undergoing unilateral TKA in two centers were randomly divided into injection group and control group. Injection group (50 cases) received local anes?thetic injection of ropivacaine (200 mg), fentanyl (1μg) and epinephrine (1∶1 000, 0.25 mg) in operation and control group (51 cas?es) did not. All patients received standardized general anesthesia and postoperative intravenous patient controlled analgesia (PCA). Preoperative baseline data, surgery?related conditions, postoperative pain (on a 0 to 10 scale), knee function, time of open?ing PCA, narcotic dosage in PCA and complications were compared respectively. Results The time of opening PCA in injection group (4-10 h, M=8 h) was longer than that in control group (2-5 h, M=4 h) (P<0.05). The 12 h, 24 h and total narcotic use of PCA in injection group (8.62±3.601 ml, 21.22±9.220 ml, 38.52±7.764 ml) was less than that in control group (18.43±9.671 ml, 35.30± 11.414 ml, 55.52±12.405 ml) (P<0.05). At post anesthesia care unit the mean VAS in injection group (2.40±1.927) was lower than that in control group (3.06 ± 2.073) (P<0.05). There was no difference in mean VAS at other time points, knee function, length of stay between two groups (P>0.05). Conclusion LIA in TKA can relieve pain early after TKA, prolong the time of opening PCA and reduce narcotic use compared with patients without it. It is simple and safe to use.

Objective To provide the skin vessels morphologie basis for perforating flap of the antero- lateral thigh(ALT).Methods Six sides lower limbs of adult fresh cadaver specimens perfused with lead oxide-gelatine mixture were used.Observe the peraforators of anterolateral thigh by dissection.The elevated tissue was radiographed by X-ray and MSCT-scanning.Computer techniques was used for the detection and 3D-reconstruction of the regions of each perforators of ALT flap.Results The three-dimensional recostruct- ed digitized visible models perfectly displayed the anatomic structures of arteries on the anterolateral thigh, and,the morphology and distribution of the vascular territory of each perforator from descending branch of LCFA was displayed in the images of 3D-visualization,their effective morphology and distribution were same, and they accord with vascular territory of radiograph.On the 2D-image of X-ray,The margins of the anatomical distribution of each perforator from descending branch of the lateral circumflex femoral artery were determined, their total areas was about 25cm?24cm.Conclusion Since the digitized image of perforator territory can accord with the morphology of anatomy,and can off vascular structure insights into cutaneous perforator anato- my,their 3D visualizative models can be applied in pre-operative designing and virtual operation procedures, and can be helped for study of perforator flap.

Objective Mutated inbred animal model is introduced to the practical course of genetic diagnosis in the hope that medical students are able to apply what they have learned to clinical cases, based on a deep understanding of principle and technology on gene mutation detection. Methods We integrated DNA extraction, polymerase chain reaction, agarose gel electrophoresis, and gel imaging analysis into a comprehensive experiment and arranged 4-year-programme undergraduates majoring in preclinical medical sciences to conduct it with the purpose of investigating the internal relations between phenotype and genotype in a hairless Uncv mouse model. Subsequently, the questionnaire aimed at evaluating learning effect on the part of students was handed out and their feedbacks were analyzed. Results More than 90% of respondents are satisfied with the general learning effect. Especially, 98. 7% of students support the enhancing effect of the new teaching mode on their research skills and 96% consider the practical course helpful to their problem-solving ability. Conclusions The introduction of mutated inbred animal model to the practical system of molecular diagnostics proves beneficial to boost students' learning effect and scientific research quality. Our practice also provokes thoughts on the further utilization of animal models in teaching system of medical sciences.